Security Audit Waiver
Company Name: _____________________________________ (the "Audited Party")
Contact Name: _____________________________________
(lastname, firstname) (Please print)
Telephone: _____________________________________
Email: _____________________________________ (Optional)
IP Address(es) to be audited: _______________________________________
Permitted time frame of audit: From Dates: ____________ to _____________
yy/mm/dd yy/mm/dd
Times: ____________ to _____________
Please initial each of the following boxes indicating your acceptance
of the statements:
( ) I am the authorized administrator or owner of the hardware to be
audited at the specified IP addresses and consent to having security
audits conducted of these addresses.
( ) I am authorized to execute this security audit waiver.
( ) I understand that an audit of an IP address may take from anywhere
from 20 minutes to up to 10 hours to run, and may consume up to
128K bit of bandwidth.
( ) I have been informed that the audits may impact the up-time of the
network and hardware being audited.
( ) To the maximum extent permissible by law, neither I nor the Audited
Party shall hold the auditor or his suppliers liable for any damages
whatsoever (including without limitation, damages for loss of business
profits, business interruption, loss of business information or any
other pecuniary loss) arising out of the use or inability to use the
auditor's service or reports, even if the auditor or his suppliers
have been notified of the possibility of such damages.
______________________________ Dated this ______ day of ________, 20____
Authorized Name (Print)
______________________________
Authorized Signature (I have authority to bind the Audited party)
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| To be filled in by Auditor
| ( ) I have verified the above information to be true and correct.
|
| Auditors Name: ______________ Auditor's Signature: ________________
| Name of account to be used: ____________
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